YMCA of the Greater Tri-Cities Employment Application Step 1 of 9 11% Your Personal InformationThank you for your interest in a job with YMCA of the Greater Tri-Cities! Name(Required) First Last Email(Required) Phone(Required)Address(Required) Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employment InformationPosition Applied For(Required) Desired Hourly Rate or Salary(Required)Hours You Are Available for Work(Required)Please tell us what hours you are available for work each day of the week.MondayTuesdayWednesdayThursdayFridaySaturdaySundayWhen will you be available to start?(Required) Are you legally eligible for employment in the U.S.?(Required)ChooseYesNoPreferred Job Status(Required) Full-Time Part-Time Seasonal As Needed Are you at least 21 years of age?(Required)ChooseYesNoDate of Birth (if under 21) Have you ever been employed by any YMCA?(Required)ChooseYesNoStart Date End Date If so, what location? Have you ever volunteered for any YMCA?(Required)ChooseYesNoStart Date End Date If so, what location? List relatives/household members working for the YMCA to avoid potential conflicts in placement. Have you ever been convicted of or plead guilty to any criminal offense (excluding non-moving traffic offenses)?(Required)Choose...YesNoHave you ever been found by a court in a civil action, a disciplinary board final hearing or in a protection proceeding to have abused or financially exploited a minor or vulnerable adult?(Required)Choose...YesNoHas a court ever taken away your custody or visitation rights to a child or vulnerable adult?(Required)Choose...YesNoHave you been convicted of a felony?(Required)Choose...YesNoIf you answered "yes" to any of the above questions.HB 1298 sec 2 “ban-the-box” does not apply to the YMCA of the Greater Tri-Cities as an employer hiring for positions that may have unsupervised access to children under the age of 18. If anwering Yes to any question, please describe here. EducationEducational Experience(Required)Please add any and all secondary and post-secondary education you have attended or completed. SchoolLocationDid you Graduate?Degree ReceivedCourse/Major Add RemoveAre you presently in school?(Required)Choose...YesNoIf yes, give your expected completion date Number of Early Childhood Education Credits(Required) How many are School-Age appropriate? If you are not a high school graduate, list the highest grade you completed If you are not a high school graduate, have you earned a GED or high school equivalency?Choose...YesNo Skills & CertificationsList only job-related certifications, licenses, and skills. Provide expiration dates if applicable.General Certificates & TrainingsFirst Aid First Aid Expires: CPR Infant/Child/Adult CPR Expires: Food Worker Permit Food Worker Permit Expires: Child Care Certificates & TrainingPortable Background Check Portable Background Check Expires: Bloodborne Pathogens Bloodborne Pathogens Date Completed STARS Basic Training STARS Basic Training Date Completed TB/PPD Test TB/PPD Test Test Date Swimming Certificates & TrainingLife Guarding Life Guarding Expiration Date WSI WSI Expiration Date Additional CertificationsLicense/Certification/TestExpiration Date Add RemoveYMCA Certificates: List other qualifications and/or skills related to the position, such as special training, languages spoken, software, typing, classes, etc. You may also list any other information you would like in this space. Employment History & Work ExperiencePlease give accurate, full-time and part-time employment records. Start with your present or most recent employer. Previous Employers Employer City/State Dates Employed Job Title Immediate Supervisor Phone Eligible for rehire? May we contact this employer? Summarize the nature of the work performed and job responsibilities. Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Please explain any gaps in your employment history.If you worked for any of the above employers under another name, please list your other name, please list your other name(s) and identify which employer. Volunteer History & ReferencesVolunteer HistoryInclude volunteer work/membership in professional or civic organizations related to this position. Exclude, if you wish, those which may disclose your race, creed, color, religion, sex, marital status, ancestry, or age.Organization NameContact NameLocationYour RoleDates Add RemovePersonal & Character References(Required)List three personal/character references; the final reference must be an immediate family member. Don't include supervisors listed in the Employment section.NameOccupationLocationRelationshipLength of AcquaintancePhone Number(s) Add Remove Driving InformationFurnish ONLY if applying for a position involving driving a YMCA-owned/leased vehicle. Participation in pre-employment and random drug testing program is required to drive YMCA vehicles.Do you have a current driver's license?YesNoState Issued CDL?YesNoDo you possess any special endorsements on your license?YesNoIf yes, please specify How many years licensed driving experience doyou have?Less than 2 years2 years3 years4 years or moreHave you had any driving violations in the last 5 years? Applying to Work With Youth?Complete these questions only if applying to work with youth. If not, move on to the next section.Why do you want to work with and care for youth?With what age group or gender do you prefer to work and why?Other than employment within your own family, what other involvement do you have with youth?What youth-focused training have you received?Have you ever molested or abused a child?(Required)Choose...YesNoNotice to All Applicants The YMCA enforces its zero tolerance policy for child abuse. Allegations or suspicions of child abuse are taken very seriously at the YMCA and will be reported to the proper authorities for investigation. We have abuse reporting procedures, there are unscheduled visits from supervisors, we have an open door for parents, and we have a code of conduct for staff. We minimize opportunities for abuse to occur and we talk with children about personal safety and touching limits. We also screen carefully to prevent abusers from being hired, including criminal background checks. We provide child abuse prevention training to staff. Review & SubmitPlease read carefully before submitting.I attest that the information provided in this application is true and correct and agree that any untruthful or misleading answers, or omission of fact, may result in rejection of this application, or dismissal if employed. I authorize and release any and all former employers, supervisors and any other persons to furnish the YMCA with information concerning my work performance, skills, abilities and character. I understand that if an offer of employment is made, employment is conditional based upon the results of background investigation(s) conducted by the YMCA and the State if employed in a DSHS/DEL licensed program. Background investigations include completion of criminal conviction and abuse/exploitation disclosure(s), DMV, and related records check(s). Additionally, previous work experience, academic history, certifications, professional licenses, etc. may be verified. Finger printing may be required of all employees. If employed, I agree that employment with the YMCA is at-will and that either the YMCA or I may terminate the relationship at any time with or without cause or notice. I further understand that neither the policies, rules, regulations of employment nor anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will. This at-will employment relationship can only be altered by the Executive Director, and any such agreement shall not be effective unless it is in writing and signed by both parties. I understand that, other than the Executive Director of the YMCA, no manager, supervisor or representative of the YMCA has authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing. I further expressly agree that, with respect to the at-will employment relationship, this constitutes the full, complete and final expression of the parties’ intent concerning the nature of any employment relationship between myself and the YMCA. If employed, I understand that I must furnish proof of my identity and legal right to work in the U.S. within three days of hire, in compliance with the Immigration Reform and Control Act of 1986. I understand that this application is only valid for the position applied for at present and that the YMCA is not obligated to retain or consider this application for future openings. I further understand that if I am employed, I am required to abide by all YMCA policies and procedures at all times. I acknowledge that I have read the above statements and understand them. Consent(Required) I have read the above statement and wish to submit my application.(Required)
